The ASCO Educational Book is a collection of articles written by ASCO Annual Meeting speakers and oncology experts. Published annually, each volume highlights the most compelling research and developments across many different fields of cancer care.

For people with cancer, making decisions with their families and doctors is an ongoing aspect of cancer care and treatment. But for some people with cancer, such as children, people with brain metastases, or older adults with cognitive impairments, they may be unable to make certain decisions for themselves.

In this podcast, Paul Appelbaum, MD; Allison Magnuson, DO; and Jonathan Marron, MD, MPH, discuss what people with cancer and their families or caregivers should know about “decisional capacity,” which is a person’s ability to make binding decisions. They also discuss why decisional capacity is important, how it’s assessed, and what to do if your loved one with cancer is unable to make decisions for themselves.

  • What is decisional capacity, and why does it matter to people with cancer and their families? [3:30]

  • Does the capacity to make decisions vary based on what decision needs to be made? [5:52]

  • What aspects of cancer and cancer care might affect a person’s ability to make decisions? [7:01]

  • How will doctors assess whether a person has the capacity to make decisions? [8:05]

  • How do doctors approach patients who don’t have decisional capacity? [12:10]

  • How can families and caregivers prepare if they need to make decisions on behalf of their loved one with cancer? [14:25]

Dr. Paul Appelbaum is a psychiatrist at Columbia University Medical Center, where he researches decisional capacity and decision-making in medical contexts. Dr. Allison Magnuson is a geriatric oncologist at the University of Rochester, where she researches older adults with cancer and older adults with preexisting cognitive impairments. Dr. Jonathan Marron is a pediatric oncologist, bioethicist, and researcher at the Dana-Farber Cancer Institute and Boston Children’s Hospital. Drs. Appelbaum, Magnuson, and Marron are co-authors on the 2020 ASCO Educational Book article, “Medical Decision-Making in Oncology for Patients Lacking Capacity.” They have no relationships to disclose related to this podcast.

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